Ankara Numune Eğitim ve Araştırma Hastanesi 1. Göz Kliniği, Ankara
Purpose: To investigate the relation of cystoid macular edema (CME) and retinopathy progression, and visual outcomes after phacoemulsification or extracapsular cataract extraction in patients with diabetes mellitus. Materials Methods: Clinical and angiographic review of 54 diabetic and 67 control patients who underwent cataract surgery in four groups was prospectively performed during a 9-month period. There were 20 diabetic patients who underwent phacoemulsification surgery in group 1, 34 diabetic patients who underwent extracapsular cataract surgery in group 2, 36 control subjects who underwent phacoemulsification surgery in group 3, and 31 control subjects who underwent extracapsular cataract surgery in group 4. Results: The highest rate of CME was observed in group 2 even with the absence of preoperative retinopathy, and the least of was in group 1. No difference was observed between groups with the aspect of the surgical technique used, whereas CME occured more often in diabetics (%33.3) than controls (%16.4) independent of the surgical technique used (p=0.026). Neither preoperative presence, nor postoperative progression of retinopathy significantly affected the onset of CME. Visual outcomes were better in patients without CME than with CME in all groups. The difference was significant in group 4 (p=0.032), and nearly significant in group 2 (p-0.067).Conclusion: CME following cataract surgery, especially when extracapsular technique is used, occurs more often in diabetic patients than non-diabetics. Performing an extracapsular cataract surgery when complicated by CME on a patient results in an unfavorable expected visual outcome independent of the patient's metabolic and retinopathy status. Phacoemulsification seems to be a safer technique in the aspect of developing CME in diabetic patients.
Keywords :
Phacoemulsification, Extracapsular cataract extraction, Diabetes mellitus, Cystoid macular edema